Quality Associates, Inc. (QAI) is helping OMHA more efficiently manage millions of paper appeals request files
The U.S. Department of Health & Human Services’ Office of Medicare Hearings and Appeals (OMHA) administers appeal hearings for the Medicare program. Created by the Medicare Modernization Act of 2003 to simplify the appeals process, the organization is responsible for “Level 3” claims appeals within the five-level structure.
OMHA has millions of paper appeals files, stored in boxes. The organization needed a way to effectively capture, manage, store and preserve its hearing requests in an electronic format.
An end-to-end scanning and document conversion process, powered by QAI and IBM (for project management, labor, secure facility, administrative support and quality control) and ibml (for scanners and capture software).
OMHA is a step closer to a paperless office – it is more efficiently managing its records and ensuring the long-term preservation and security of all documentation.
Since OMHA opened its doors in 2005, it has processed approximately 585,000 appeals, representing millions of pages of written hearing requests. Unprocessed appeals in backlog, which were previously stored at a National Archives and Records Administration (NARA) warehouse in Dayton, Ohio, numbered more than 9,500 boxes. On top of that, OMHA receives thousands of new hearing requests each week.
With the goal of creating a paperless office environment and complying with the Presidential Directive on Managing Government Records, OMHA sought a way to capture, manage, store and preserve these hearing request files in an electronic format. As a result, the organization would be able to more easily search for, retrieve and view appeal files and the information they contain.
OMHA contracted Quality Associates, Inc. (QAI), a leader in enterprise-class services and solutions for content management and document management, to spearhead the project. QAI worked with its partners, IBM and ibml, to devise a secure, sophisticated, customized scanning and electronic document management solution capable of processing 1 million pages per month.
Consisting of scanners, analytics software and quality control procedures, the solution entails a LEAN, Six Sigma process to ensure an effective, pull-based workflow. First, staff members inventory each box of records, creating file names and associated barcode labels. This information is entered into an IBM-developed inventory tracking system, which tracks the boxes and files as they move through the scanning process.
Next, the boxes of files move into the document deconstruction and preparation stage. Once files are taken out of their folders and paper clips, sticky notes and other items are removed, the documents are placed in a stack. As each document is scanned using ibml’s ImageTrac-Lite scanner, ibml’s SoftTrac Capture Suite (SCS) – a modular software solution for centralizing data capture management from document receipt to information reporting – reads the barcode and intelligently names the file within the system. With the ability to scan 286 pages per minute, the ImageTrac provides the capacity to handle OMHA’s sizeable backlog.
“When handling large volumes, the process is one of the biggest pieces of the solution,” said Justin Fielder, project manager, QAI. “Determining how to make the process flow from end to end was key for OMHA’s case.”
Once the documents are scanned, ibml’s SCS Quality Control module processes each image to remove imperfections and rotate documents. Next, QAI’s quality assurance (QA) team performs an image check, manually reviewing each and every image to ensure proper manipulation, accurate folder/file names, readability and more.
In addition to paper files, QAI is converting images from CDs, which are pulled out of the boxes at the beginning of the inventory process, indexed and put into the queue. When the corresponding box enters the scanning process, the software connects the CD image information with the box’s digitized files.
After the documents pass quality control, they are converted into searchable PDFs using ibml’s SCS PostScan module. The entire scanning and capture process is centrally managed by ibml’s SCS Analytics, which provides a holistic view of performance metrics across the capture operation.
- Per Minute: 286 pages
- Daily: 30 boxes with 1,800 pages per box = 54,000 pages/images
- Weekly: 270,000 images/pages
- Monthly: 1 million+ images/pages per month
The QAI-designed solution is processing 30 boxes a day, consisting of 1,800 pages per box, for a total of 54,000 images/pages daily. This throughput rate allows QAI to process approximately 270,000 images/pages per week, thereby meeting OMHA’s requirement of scanning 1 million images/pages per month. Thus far, QAI has taken possession of more than 5,600 boxes with 10 million pages.
With its large backlog of files scanned and indexed, OMHA is one step closer to a paperless office. It is also achieving the goal of more efficiently managing its records and ensuring the long-term preservation and security of all documentation.
Nancy Fuller, program analyst, OMHA, said, “QAI is making our document management efforts a pull versus push-based process, while fulfilling our need for capturing, managing, storing and preserving our paper files in an electronic format. The company has been very thorough, very professional and very proactive throughout the engagement, keeping our staff involved along the way.”